Wagner, Kent R

Wagner, Kent R is an individual health care provider with primary practice located at 311 E Spruce St , Garden City KS 67846-5679. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Wagner, Kent R can be contacted via phone (620) 275-3700.

Contact Information

Primary practice address
311 E Spruce St Garden City KS 67846-5679
Phone: (620) 275-3700
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1500742 Kansas

Profile Details

NPI number 1629062302
LBN Legal business name Wagner, Kent R
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 8th, 2005
Last updated Apr 25th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629062302 NPPES
Kansas MEDICAID 100399780A

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